House Joint Resolution 653 (Delegate Gooditis) requested that the Virginia Department of Health (VDH) study barriers and solutions to co-locating naloxone in Automatic External Defibrillators (AEDs) as well as propose and implement an education program. The resolution was tabled in House Rules Committee with the understanding that the Joint Commission on Health Care (JCHC) would include a study of the issue in its 2019 workplan for member consideration. A subsequent letter from Delegate Gooditis requested that JCHC focus on: whether removing barriers to administering naloxone in public places is likely to save lives without causing significant damage to public health; and whether/how naloxone can be placed in publicly accessible places, such as alongside AEDs.

A combination of federal actions/funding and state-level policies have increased accessibility to naloxone – generally regarded as a safe antidote to an opioid overdose – to the general public. Although evidence suggests that naloxone can be successfully administered by lay rescuers without specialized training, opioid overdose-related training and education may be important in ensuring that the most effective response is taken. A limited number of localities and one state across the U.S. have experience with positioning naloxone in public places, and data from Virginia suggest that approximately 50% of fatal opioid overdoses occurring outside of the home take place in close proximity to a variety of public places where naloxone could be positioned.

Recommendations were made relating to naloxone training and education, positioning naloxone in public places, and addressing supply-/demand-side barriers to community-based naloxone availability. These included: authorizing public places to maintain naloxone on their premises with trained staff authorized to administer naloxone; exploring opportunities to expand the capacities or reach of other sources of opioid-related information (e.g., 911 call centers, regional Poison Control Centers); requesting that the Board of Pharmacy re-emphasize in its communications to regulated professions that Virginia law permits dispensing of naloxone without a patient-specific prescription; and broadening criminal and civil liability protections for possession and administration of naloxone regardless of the channel through which naloxone was obtained.

Five policy options were presented for consideration by Joint Commission on Health Care members and they voted against the option to take no action and approved all of the other options.